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A little financial squeeze

What if you were told that you had to cover an extra $600.00 per month in expenses, effective immediately?  Think about that for a moment.  What would you have to give up?  What would your family have to do without?  Would it even be possible?

This is a reality for many people who have been injured in car accidents.  Each treatment can cost in the $50.00 range, and many injured people require treatments three times per week.

Thank goodness for insurance!!!  Some of us have extended medical insurance through our work that covers most or all of that expense, but what about when you reach your annual maximum?  What about the most vulnerable people and families who have no extended medical insurance?

What about auto insurance?

If you were not at fault in the crash, the law says that you are entitled to complete reimbursement for any treatment expenses you reasonably have to pay as a result of your injuries.  That entitlement is against the negligent driver who caused the crash.  You make your claim for compensation through the negligent driver’s auto insurance company, and instead of dealing with the negligent driver you deal with an insurance adjuster.

On the one hand, I can assure you that the insurance adjuster knows this very obvious piece of the law.  On the other hand, I will remind you of what I have posted previously, that it is the adjuster’s duty to try to settle injury claims for as little as possible.

In the context of treatment expenses, what tactics do insurance adjusters use for settling injury claims for as little as possible?  I’ve never seen an insurance adjuster’s play book, but I’ve seen how my clients have been dealt with and I have my theories.

In the early stages of a claim, it is not uncommon for the adjuster to reimburse an injured claimant 100% of treatment expenses.  Is that a tactic or is that just being fair and reasonable?  The fact that I have had clients immediately cut off the 100% reimbursement when the adjuster found out that I have been hired leads me to think tactic.  What purpose could that tactic serve?

If the injured claimant can be lulled into believing that she will be dealt with fairly, then she will be more likely to trust the insurance adjuster when the adjuster tells the claimant what the claim is worth.  Of course, the person whose job it is to negotiate as low a settlement as possible is the last person you should trust!

By holding the purse strings, the insurance adjuster holds a lot of power.  Once a level of trust has built up, pressure can be put on the injured claimant by simply turning off the tap.  After a claimant has been relying on 100% funding for treatments for a number of weeks or months, how better a way to “encourage” an unfair settlement but to put on a little financial squeeze.

Some injured claimants respond to the financial squeeze by stopping treatment, which is absolutely the worst thing to do.  Doctors recommend treatment for a reason.  The very best outcome of any car crash injury is to recover and have as small a claim as possible.  By stopping treatment, you are jeopardising your recovery.  You are also hurting your case, opening yourself up to two arguments that the very insurance company putting on the squeeze can make at trial.

One argument is that you are to blame for your ongoing pain because you failed to continue with doctor recommended therapy.  Another is to point to your treatment pattern and say “Look, she must have gotten better because she stopped her treatment”.

Get a line of credit; refinance your mortgage; borrow from family or friends.  Do whatever it takes to finance those treatments.  Allow your doctor’s advice to determine your medical treatment, not the financial squeeze of an insurer turning off the tap.  It is only the most vulnerable, without access to any financing, who are actually forced into stopping treatment, unless extremely generous treaters are willing to provide treatments on credit.

Published February 11, 2007 in the Kelowna Capital News